| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,583 |
2,396 |
$138K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,559 |
1,428 |
$119K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,120 |
2,104 |
$92K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
587 |
587 |
$41K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
438 |
438 |
$31K |
| 90461 |
|
518 |
513 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
459 |
436 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
189 |
188 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
53 |
$4K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 96127 |
|
298 |
289 |
$1K |
| 99422 |
|
42 |
36 |
$880.64 |
| 0071A |
|
19 |
19 |
$475.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
43 |
43 |
$373.03 |
| 0072A |
|
13 |
13 |
$325.00 |
| 87428 |
|
15 |
14 |
$318.70 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$308.76 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
27 |
27 |
$207.42 |
| 96160 |
|
113 |
113 |
$130.26 |
| 96156 |
|
86 |
86 |
$45.00 |
| 90473 |
|
25 |
25 |
$10.00 |
| 90686 |
|
591 |
591 |
$0.00 |
| 1111F |
|
1,358 |
1,337 |
$0.00 |
| 90697 |
|
13 |
13 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 3008F |
|
384 |
383 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| 91307 |
|
32 |
24 |
$0.00 |
| 90670 |
|
75 |
75 |
$0.00 |
| 90685 |
|
49 |
48 |
$0.00 |
| 90661 |
|
56 |
56 |
$0.00 |
| 91300 |
|
13 |
12 |
$0.00 |
| 1033F |
|
21 |
21 |
$0.00 |
| 99177 |
|
14 |
14 |
$0.00 |